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The Problem with Medicaid Work Requirements

Kevin Lamarque

By The Fiscal Times Staff

September 24, 2018

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The New York Times’ Margot Sanger-Katz writes that there’s a “big problem” with Medicaid work requirements that the Trump administration says are meant to encourage low-income Americans to work, volunteer or go to school as a path to pull them out of poverty.

More than 4,300 people lost coverage after a new test program in Arkansas imposed work requirements on about 60,000 Arkansans, and thousands more could lose coverage over the coming months simply because of the difficulties involved in making beneficiaries aware of the work-reporting requirements and getting them to comply.

“The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours,” Sanger-Katz writes. “Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” Only 279 people reported work activities.

The Trump administration has been upbeat about the early results, but “[a]dvocates for the poor, and the state officials in charge of the program, said the low compliance numbers suggested that many eligible people probably didn’t know the program existed,” Sanger-Katz says. Low rates on internet access — required to report work hours — and a website that critics call confusing are part of the problem. And one expert opposed to Medicaid work requirements says that the state could have done a better job of informing beneficiaries about the new requirements if it had been willing to spend more money to do so.

The Arkansas program is being challenged in court and will be reviewed by a federal judge who has already struck down a similar proposal in Kentucky, ruling that the state hadn’t demonstrated sufficient concern about people who might lose coverage. “In Kentucky, those losses were theoretical,” Sanger-Katz notes. “In Arkansas, they’re already real.”